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KENTUCKY CVS PHARMACY, L.L.C.
CH04814E HEALTHFIRST BLUEGRASS, INC.
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Covered Entity Details
Entity Name
HEALTHFIRST BLUEGRASS, INC.
Subdivision Name
HealthFirst Bluegrass Mobile 2 Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH04814E
Entity Address
496 Southland Drive
Lexington, KY 40503-1827
Grant Number
H80CS28202
Participating Start Date
1/1/2017
Last Recertification Date
1/31/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
KENTUCKY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06942
3097 TODDS RD.
LEXINGTON, KY 40509
Pharmacy Comments
Contract Details
Approval Date
1/9/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Wayne Linscott, CEO
(859) 270-0192
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/9/2023
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